In 2004 the life expectancy for men and women in the Untied States was 75.2 and 80.4 years, respectively, according to the National Center for Health Statistics Web site.
Plagued by less healthy lifestyle attitudes -- including more drinking and smoking, resistance to seeking medical attention, engagement in riskier behavior and involvement in stressful work -- men are at greater risk of dying from heart disease, stroke, cancer, diabetes and many other diseases.
For Stanford Provost John Etchemendy, it was the stress involved in taking on such a high-profile and demanding position in 2000 that made his health deteriorate. He was gaining weight, not sleeping well and suffering from periodic insomnia. His previously normal cholesterol and blood-pressure levels were climbing to borderline high. He had very little energy, and by the end of his first year serving as provost he had a bleeding ulcer.
"It wasn't clear to me that I would stay on as provost much beyond that year, given the way I was feeling," Etchemendy said.
All this prompted Etchemendy to get a heart-stress test.
Many men see their doctors only when they experience physical symptoms, when their significant others pressure them to do so or when they have a close family member who has suffered from health problems, said Dr. Douglas Souvignier, the primary care division head at Camino Medical Group, Mountain View, an affiliate of the Palo Alto Medical Foundation.
"Men are half as likely to visit a doctor for a checkup as women are, and there are over 7 million American men who haven't seen a doctor in over 10 years," according to the "Blueprint for Men's Health," a publication of the Men's Health Network.
Dr. Souvignier noted that men tend to ignore their aches and pains, attributing shortness of breath or discomfort in the chest to heartburn or signs of aging, when they could be signs of coronary disease. He also notes that men need to "overcome their doctor anxiety.
"Many men are worried about uncomfortable tests, and that may keep them away....We don't want to scare men away." Although it may be uncomfortable, most of the time it's a pretty relaxed and helpful discussion, he said.
Etchemendy, a former smoker, admits that he has the tendency when he's not feeling well or engaging in unhealthy behavior to avoid the doctor because "you know what the doctor is going to tell you....so it feels more like scolding than anything else, so you naturally as a human being avoid that."
Women are aided by yearly reminders to see the doctor in their younger to middle years with annual tests such as pap smears. But because there are no yearly screenings for men, "it makes it hard for men to remember to get checked," said Dr. Souvignier.
Aside from lifestyle choices, men are also more vulnerable because heart disease begins at a younger age in men than in women, owing to the protective effects of estrogen. Heart disease is currently the leading cause of death for men in the United States, with cancer a close second. One of the most common misperceptions Dr. Souvignier encounters with his male patients is that they don't think heart disease can occur in younger men in their forties or even late thirties.
"More than half of these premature deaths are preventable, along with about 60 percent of chronic diseases," according to the "Blueprint for Men's Health."
Etchemendy took control of his health by exercising regularly and moderating his diet. While the aches and soreness of getting into a regular workout routine were painful at first, he now within a week goes to the gym three times, swims at least four times, and takes one or more long, strenuous bike rides. He continues to eat whatever he wants for breakfast and dinner, but has replaced all tempting junk food that appears during meetings and receptions throughout the day with fruit.
As a result he's down to 145 pounds from his previous weight of more than 200, and his cholesterol level is considered low. His insomnia has disappeared, and although the demands of his job haven't changed, his stress levels have gone down and he feels more in control.
"I don't think I ever imagined how good you could feel by being in shape," he said.
"I think people misperceive the effect of diet on cholesterol. Many studies show that diet has very little effect on blood cholesterol. What can change your cholesterol is exercise. It absolutely has a great effect," he added.
Dr. Souvignier suggests that the first step is for men to develop healthy lifestyle habits in their twenties. This includes regular exercise and sleep, maintaining a healthy diet, stress management and avoiding excessive alcohol and smoking. In their thirties and forties, men should get periodic health exams every three to five years, including checking their body mass index, blood sugar, blood pressure, cholesterol and lipid levels.
Into the fifties and above, there are more specific recommendations and tests, including screenings for prostate and colon cancers. After the age of 50, prostate-specific antigen tests are recommended annually, and colonoscopies are recommended once every 10 years.
But even if men don't develop good habits in their younger years, it's not too late, said Etchemendy, 55, who didn't begin exercising regularly until a few years ago. "There's no particular reason that you can't at age 50 feel as in good shape as you did when you were 20."
And with such an outlook, perhaps there's no reason that men can't narrow the life expectancy gap with women.